AB0574 PREDICTOR FACTORS IN EMPOWERMENT OF PATIENTS WITH PRIMARY SJOGREN SYNDROME IN THE FRAME OF VALUE BASED HEALTH CARE
Authors: G. Mumcu, K. Abacar, İ. Tatli, F. Türe-Özdemir, O. C. Kitapçi, N. Şişman Kitapçi, M. Yay, Ü. Karaçayli, F. Fortune, N. Inanc
Journal: Annals of the Rheumatic Diseases (2022)

Background Patient empowerment is a key component in developing awareness of the disease in patient-centred care in the setting of chronic disease management. Objectives This study aimed to evaluate predictive factors in the empowerment of patients with Sjögren’s Syndrome (pSS), while examining patients reported outcome measures (PROMs) in the setting of value-based health care. Methods In this cross-sectional study, 169 patients with pSS (F/M: 162/7; mean age: 52.94±12.20 years) were included. Data was collected from the clinical examination, major salivary gland ultrasonography (SGUS) and a structured questionnaire regarding utilisation of health services and PROMs regarding Oral Health Impact Profile-14 (OHIP-14), Hospital Anxiety and Depression Scale (HADS; HADS-Anxiety and HADS-Depression) and Self-reported General Health Status (100-m VAS; 0: very poor vs 10: very good). Both stimulated (S-SFRs) and unstimulated salivary flow rates (U-SFRs) of patients were measured as ml/min. Patients with hyposalivation were grouped as according to U-SFR (≤0.1 ml/min). Furthermore, Outcome Measures from Rheumatology ultrasonography (OMERACT US) scores (from 0: normal to 3 points: severe inhomogeneity) were collected to evaluate glandular involvement of patients. After initial statistical analyses was carried out, mediation analysis was performed to evaluate the associations. Results The rate of patients with hyposalivation was found as 45% and most (85.7%) had elevated SGUS scores (≥2 points). In addition, self-reported oral health problems were common in the study group (from 23.8% to 53.4%). Among this cohort, the patients suffered from Burning oral sensation (27 %) had poor scores in OHIP-14 (29.81±14.48 vs 20.22±12.43), HADS-Depression (10.07±4.49 vs 6.65±4.20) and Self-reported general health status (45.43±17.95 vs 55.56±22.43) compared to those without Burning oral sensation (p=0.006, p=0.019, p=0.018, respectively). Furthermore, significant correlations were observed between OHIP-14 score and HADS-A score (r: 0.4 p: 0.004) and HADS-D scores (r: 0.58 p=0.000). Utilising mediation analysis, the HADS-Depression score was directly mediated by the presence of Burning oral sensation (p=0.0005) and indirectly mediated by OHIP-14 score (p=0.0360). In this group, the interval from the last dental visit was mean: 19 months. Interestingly, 60% preferred to relate their oral discomfort during visits (3 times a year), to rheumatologists. Conclusion Better health outcomes could be achieved by reducing oral discomfort, increasing dental visits, improvement of oral health related quality of life and managing depression by a multidisciplinary team with dentists and psychiatrists in patient-centred care. Since these factors have a significant effect on patients’ daily life, treatment plans are needed to provide patient empowerment by using suitable strategies in the frame of value-based health care. Disclosure of Interests None declared